Welcome to the Payor/Provider Convergence Series of the Health Care Law Today blog. This series is dedicated to exploring the intersection between payors and providers in the health care space; in particular, the evolving...more
5/4/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
False Claims Act (FCA) ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Knox Keene ,
Medicare Advantage ,
No Surprises Act (NSA) ,
Public Health Emergency
Each state Department of Insurance requires that insurance producers — brokers and agents — keep their information up to date in the DOI's records by timely notifying the DOI of any changes to the producer's information,...more
Air ambulance services often result in large, unanticipated medical bills for patients. A study by the Government Accountability Office found that in 2017, 69% of air ambulance transports provided to individuals covered by...more
10/19/2022
/ Deadlines ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
GAO ,
HCPCS ,
Health Insurance ,
Health Plan Sponsors ,
No Surprises Act (NSA) ,
Proposed Rules ,
Third-Party ,
U.S. Treasury
Earlier this month, the Department of Labor (DOL) released its Final Rule seeking to expand the scope of participation in Association Health Plans. The Final Rule, titled “Definition of ‘Employer’ under Section 3(5) of ERISA...more
Telemedicine providers can sell their services in a number of ways. Consumers, self-funded health plans, and health insurance companies are all important and growing customers for many telemedicine providers. Telemedicine...more
7/3/2018
/ Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
HMOs ,
Insurance Code ,
Physicians ,
Risk Mitigation ,
Self-Funded Health Plans ,
Service Contracts ,
Telehealth ,
Telemedicine
Purchasers of consumer goods are more discerning than ever before, and thanks to the internet, have access to more choices and more information every day. Manufacturers that are perceived as producing high-quality products...more
2/16/2018
/ Business Model ,
E-Commerce ,
Extended Warranties ,
Internet Retailers ,
Manufacturers ,
Registration Requirement ,
Retailers ,
Revenue Growth ,
Service Contracts ,
Subsidiaries ,
Suppliers ,
Third-Party Service Provider ,
Warranties
Congress is now back in session and, once again, focus has turned to health care. With all eyes on returning health care reform to the forefront, a flurry of activity has sparked new legislative efforts including the...more
9/19/2017
/ Affordable Care Act ,
Federal Grants ,
Health Insurance ,
Health Savings Accounts ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid Expansion ,
Medicare ,
Political Parties ,
Repeal ,
Trump Administration
On July 13th, the Senate released the updated version of the Better Care Reconciliation Act (BCRA) of 2017. While the new version makes some significant changes to the original Senate proposal, the major components of the...more
On June 21, 2017, Governor Scott Walker signed Senate Bill 77 into law as 2017 Wisconsin Act 16, which permits its domestic insurers to become domestic surplus lines insurers (DSLIs) and sell surplus lines insurance in...more
After weeks of secrecy, the Senate has released a discussion draft of legislation that is the counterpart of the American Health Care Act (AHCA) previously passed by the House. The Senate legislation, entitled the Better Care...more
6/28/2017
/ Affordable Care Act ,
Block Grants ,
Cadillac Tax ,
Congressional Budget Office ,
Cost-Sharing ,
Dependents ,
Essential Health Benefits ,
Flexible Spending Accounts ,
Health Insurance ,
Health Savings Accounts ,
Healthcare Reform ,
High Risk Pools ,
Legislative Agendas ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Penalties ,
Planned Parenthood ,
Political Parties ,
Preexisting Conditions ,
Prescription Drugs ,
Proposed Legislation ,
Repeal ,
Tax Benefits ,
Trump Administration ,
Waivers
On Monday, two House committees with oversight over health care and taxation, Energy and Commerce and Ways and Means, released draft reconciliation bills designed to repeal and alter significant portions of the Patient...more
3/9/2017
/ Affordable Care Act ,
Employer Mandates ,
Health Insurance ,
Health Savings Accounts ,
Individual Mandate ,
Legislative Agendas ,
Medicaid ,
Planned Parenthood ,
Proposed Legislation ,
Repeal ,
State Health Insurance Exchanges ,
Tax Penalties
Section 1557 of the Affordable Care Act (“ACA”) establishes a broad prohibition on discrimination on the basis of race, color, national origin, sex, age or disability in health programs and activities. After almost 3 years of...more
The National Association of Insurance Commissioners (NAIC) Spring 2016 National Meeting, which was held from April 3 – 6 in New Orleans, offered insight into numerous issues being considered by state commissioners nationwide....more
4/19/2016
/ Accreditation ,
Affordable Care Act ,
Annuities ,
Big Data ,
Cybersecurity ,
Department of Labor (DOL) ,
Fiduciary Duty ,
Health Insurance ,
Insolvency ,
Insurance Industry ,
Life Insurance ,
Mortgage Insurance ,
NAIC ,
NARAB ,
Peer-to-Peer ,
Popular ,
Receivership ,
Reinsurance ,
Sharing Economy ,
Surplus Lines Insurance ,
Workers Compensation Reform
On November 11, 2015, Governor Scott Walker signed Senate Bill 287 into law as 2015 Wisconsin Act 90. The law is a collection of miscellaneous changes and updates to Wisconsin’s Insurance Code, including technical corrections...more
As expected, on Monday, November 9, 2015, the U.S. Department of Health & Human Services (HHS) filed a Notice of Appeal from the decision issued by Judge Royce Lamberth of the United States District Court for the District of...more
Telehealth opportunities continue to grow at an exponential rate, aligning with the concurrent growth of retail and consumer-focused medicine. Capturing the retail sentiment, companies are looking to offer subscription-based...more
10/6/2015
/ Alternative Payment Models (APM) ,
Fees ,
Fixed Price ,
Fixed-Fee ,
Health Care Providers ,
Health Insurance ,
Licensing Rules ,
Retail Market ,
Risk-Based Approaches ,
Telehealth ,
Telemedicine
The Iowa Commissioner of Insurance (the “Commissioner”) filed a petition, on January 29, 2015, seeking to liquidate CoOpportunity Health, Inc. (“CoOpportunity”), a Consumer Operated and Oriented Plan (“CO-OP”) established...more
The U.S. Supreme Court’s decision in United States v. Windsor, issued two weeks ago, held that a portion of the Defense of Marriage Act (DOMA) was unconstitutional. This decision will affect individuals, employers, and...more